Insurance Type | ACA (Obamacare) |
Plan Name | KP GA Bronze 6200/40%/HSA |
Plan ID | qhp-89942GA0050009 |
Plan Year | 2019 |
Insurance Provider | Kaiser Permanente |
Metal Level | Bronze |
Plan Type | HMO |
Deductible | $6,200 |
Out-of-Pocket Maximum | $6,550 |
Personal Score | |
Plan Highlights |
Costs for Medical Care | |
---|---|
Primary Care Visit to Treat an Injury or Illness | 40% Coinsurance after deductible |
Specialist Visit | 40% Coinsurance after deductible |
Laboratory Outpatient and Professional Services | 40.00% Coinsurance after deductible |
X-rays and Diagnostic Imaging | 40.00% Coinsurance after deductible |
Deductible - Family | $12400 |
Out-of-Pocket Maximum - Family | $13100 |
Prescription drug coverage | |
---|---|
Generic Drugs | 40% Coinsurance after deductible |
Preferred Brand Drugs | 50% Coinsurance after deductible |
Non-Preferred Brand Drugs | 50% Coinsurance after deductible |
Specialty Drugs | 50% Coinsurance after deductible |
Access to doctors and hospitals | |
---|---|
Provider directory URL | Coming Soon |
Hospital services | |
---|---|
Emergency Room Services | 40% Coinsurance after deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | 40% Coinsurance after deductible |
Inpatient Physician and Surgical Services | 40% Coinsurance after deductible |
Maternity | |
---|---|
Prenatal and Postnatal Care | 40.00% Coinsurance after deductible |
Mental Health | |
---|---|
Mental/Behavioral Health Outpatient Services | 40.00% Coinsurance after deductible |
Mental/Behavioral Health Inpatient Services | 40.00% Coinsurance after deductible |
Vision Coverage | |
---|---|
Routine Eye Exam for Children | 40.00% Coinsurance after deductible |
Eye Glasses for Children | Not Applicable |
Exclusions and Limitations | |
---|---|
More Included Benefits | Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Durable Medical Equipment Imaging (CT/PET Scans, MRIs) Preventive Care/Screening/Immunization Rehabilitative Speech Therapy Other Practitioner Office Visit (Nurse, Physician Assistant) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Hospice Services Urgent Care Centers or Facilities Home Health Care Services Inpatient Physician and Surgical Services Skilled Nursing Facility Rehabilitative Occupational and Rehabilitative Physical Therapy Well Baby Visits and Care Transplant Accidental Dental Dialysis Allergy Testing Chemotherapy Radiation Diabetes Education Prosthetic Devices Infusion Therapy Treatment for Temporomandibular Joint Disorders Nutritional Counseling Reconstructive Surgery |
More Excluded Benefits | Acupuncture Hearing Aids Routine Foot Care Weight Loss Programs Dental Check-Up for Children Infertility Treatment Long-Term/Custodial Nursing Home Care Private-Duty Nursing Bariatric Surgery Cosmetic Surgery Abortion for Which Public Funding is Prohibited |
Premium | Plan Name | Deductible | |||
---|---|---|---|---|---|
from $330 |
| $6,200.00 | Select | ||
from $342 |
| $6,000.00 | Select | ||
from $344 |
| $6,000.00 | Select | ||
from $370 |
| $6,000.00 | Select | ||
from $383 |
| $6,000.00 | Select |
Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Generally speaking, a Bronze Plan is intended to have the lowest premium of the 4 new categories of health plans under the Affordable Care Act but charge the highest out-of-pocket costs for healthcare services.
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Bronze Plan pays 60% of the covered medical costs among its enrollees while the other Obamacare health plans pay a higher percentage of these costs.
The monthly premium for a Bronze Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Bronze Plan premiums in your area. Another important factor to remember is Advanced Premium Tax Credits which can subsidize bronze plan premiums if an individual meets eligibility criteria.
The annual enrollment period for the 2018 plan year will begin on November 1, 2017 and continue through December 15, 2017.
In 2015 there had been a Special Enrollment Period for many facing the uninsured penalty on their 2014 tax return. There is no guarantee that a similar Special Enrollment Period will be granted in 2017. See our Open Enrollment article for more information.
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.
HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.